Development of Hodgkin lymphoma in a patient with sarcoidosis

Sarcoidosis is a chronic granulomatous disease of unknown etiology characterized by non-caseified granulomas in many different organs and systems. The disease most frequently manifests with bilateral hilar lymphadenopathy and infiltrations in the lungs and skin, as well as with eye lesions. It may mimic a number of systemic diseases and/or accompany them. The development of lymphoma in patients with sarcoidosis or the co-occurrence of both diseases is rarely reported in the literature. In this paper we report a female patient followed up with sarcoidosis for three years who developed Hodgkin lymphoma, according to the results of the investigations and biopsy results.

The clinical and pathological features of patients with hematological neoplasms: a study of hospital-based Cancer Registry from western Turkey

PURPOSE

To evaluate the frequency and the main features of patients with hematological neoplasms (HNs) who were diagnosed between 1992-2005 at the Izmir Ataturk Education and Research Hospital (IAEAH), affiliated with Izmir Cancer Registry (ICR) database.

METHODS

A total of 2,424 HNs were recorded with reference to ICD-0-3 according to Surveillance, Epidemiology, and End Results (SEER) data among 20,895 recorded cancer patients from 1993 to 2005. The percentages of male and female patients were 58.5% and 41.5%, respectively. The age ranges were as follows: 15-44 years (37.3%), 45-64 (36%), and > 64 (26.6%). One thousand and nineteen (56%) patients had B cell and 108 (5.9%) patients had T/NK (natural killer) cell lymphoid neoplasms. One hundred and ninety-four (10.7%) patients had lymphoblastic leukemia, 267 (14.7%) had Hodgkin's lymphoma (HL), and 603 (24.9%) had myeloid leukemia. Three hundred and five (16.7%) patients had extranodal involvement (in 1821 regions). The major extranodal location was the stomach.

CONCLUSION

It seems that our data make a contribution to the relevant literature, because the epidemiologic data of Turkey are inadequate, and hematopoietic neoplasms have different geographic distribution.

Does imatinib mesylate therapy cause growth hormone deficiency?

OBJECTIVE

The purpose of this study was to determine whether or not imatinib mesylate therapy induces growth hormone deficiency (GHD).

SUBJECTS AND METHODS

Seventeen patients with chronic myloid leukemia (CML) were enrolled in the study. The glucagon stimulation test (GST), and standard deviation scores (SDSs) of insulin-like growth fac- tor 1 (IGF-I) and insulin-like growth factor binding protein (IGFBP-3) were used to determine GHD. The L-dopa test was performed on those with IGF-I SDSs above the -1.8 cut-off level.

RESULTS

Of the 17 patients in the study, 12 (70%) had severe GHD (serum GH level <3 microg/l after GST). IGF-I SDSs and IGFBP-3 SDSs were below -1.8 in 12 patients (70%) and below -0.9 in 10 subjects (58%). Four of the 5 remaining subjects with IGF-I SDS >-1.8 showed insufficient GH response to L-dopa stimulation. Nine subjects (52%) had both severe GHD based on GST response and IGF-I SDS below -1.8. If an IGF-I SDS cut-off value l<-3 were used,5 out of 17 subjects (30%) would be classified as GH deficient. These same patients also showed severe GHD based on GST response.

CONCLUSIONS

The data showed that a large number of patients on imatinib mesylate therapy had GH deficiency. A study involving a larger number of patients with a matched control group is needed to confirm the present observations.

Extramedullary plasmacytoma of the parotid gland. Report of a case with extensive amyloid deposition masking the cytologic and histopathologic picture

BACKGROUND

Extramedullary plasmacytomas are uncommon. Although approximately 90% occur in the head and neck region, parotid gland localization is extremely rare.

CASE

This report describes fine needle aspiration and histopathologic findings in an extramedullary plasmacytoma arising in the left parotid gland of a 62-year-old man. Aspiration smears showed multiple amorphous clumps of material admixed with ductal epithelial cells, multinucleated giant cells and inflammatory cells rich in plasma cells, suggestive of pleomorphic adenoma. In surgical material, excessive amyloid deposition was observed. Six months later the tumor recurred, and in the second surgical specimen clusters of atypical plasma cells among amyloid deposits was noted. Clinical and laboratory examination excluded multiple myeloma. After local recurrence, radiotherapy was applied. Ten months later the patient was well and without systemic involvement.

CONCLUSION

Two points are important. First, in the salivary gland region, because of the focal metachromasia of amyloid with Giemsa stain, amyloid can be confused with the chondromyxoid matrix of pleomorphic adenoma. Second, although localized forms of amyloid tumor exist, one should keep in mind that amyloid may be so abundant that it may mask an underlying plasma cell neoplasm, as in our case.

Paraneoplastic cerebellar degeneration in association with Hodgkin's disease: a report of two cases

Two patients with paraneoplastic cerebellar degeneration accompanying Hodgkin's disease were treated with plasma exchange in combination with chemotherapy or radiation therapy, respectively. Significant improvement in neurologic symptoms was obtained in 1 of them.